Pathologic changes seen in the synovium in RA consist of nonspecific inflammation and increases in synoviocytes. Lymphocytes and macrophages infiltrate affected joints, and lymphoid follicles with germinal centers of proliferating B cells surrounding dendritic cells can be seen. These pathogenetic changes may be seen within rheumatoid nodules that can occur in any organ. Further neoangiogenesis and synovial lining hyperplasia lead to destruction of cartilage and bone. In other organs, inflammatory infiltrates, vasculopathy, and fibrosis may be present as well.
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